Sift 


COL.  GEORGE  WASHINGTON  FLOWERS 
MEMORIAL  COLLECTION 


DUKE  UNIVERSITY  LIBRARY 
DURHAM,  N.  C. 


PRESENTED  BY 

W.  W.  FLOWERS 


Digitized  by  the  Internet  Archive 
in  2013 


http://archive.org/details/annualreportofciOOchar 


ANNUAL  REPORT 


OF  THE 


CITY  REGISTRAR, 


COMPRISING 


RETURN  OF  DEATHS, 

WITH  A  CLASSIFICATION  OF  THE  DISEASE,  AGE,  SEX, 
STATUS  AND  NATIVITY  OF  EACH  CASE, 

FOR  SHE  YEAR  ENDING 

DECEMBER   31st,  18(57. 


CHARLESTON. 
Joseph  walker,  agt.,  stationer  and  printer 

No.  3  Broad  Street. 

1868. 


ANNUAL  REPORT 

I 

OF  THE 

CITY  REGISTRAR, 

COMPRISING 

RETURN  OF  DEATHS, 

WITH  A  CLASSIFICATION  OF  THE  DISEASE,  AGE,  SEX, 
STATUS  AND  NATIVITY  OF  EACH  CASE, 

FOR  THE  YEAR  ENDING 
DECEMBER  31st,  18G7. 


CHARLESTON. 
JOSEPH  WALKER,  Act.,  STATIONER  AND  PRINTER, 
No.  3  Broad  Strbbt. 


1868. 


■V 


mm\  §qm1  of  the  $itj>  fjUjjisita. 


 o  

OFFICE  OF  CITY  REGISTRAR,  ) 
Charleston,  S.  C,  March  30th,  1868.  j 

To  the  Hon.  the  Mayor  and  Aldermen  of  Charleston,  S.  C: 

Gentlemen  :  The  subjoined  "  Reports,"  comprising  Mortuary 
and  Meteorological  Tables  for  the  year  ending  31st  of  December, 
1867,  are  herewith  respectfully  submitted  for  3-our  consideration 
and  approval. 

These  statistics  embrace  a  classification  of  the  Causes  of 
Death,  Age,  Sex,  Status  and  Nativity,  of  each  case ;  together 
with  Abstracts  of  the  Barometer,  Thermometer,  Dew  Point, 
Winds  and  Weather,  at  Charleston,  for  the  same  period,  and 
also,  the  accompanying  "Health  Department  Tables." 

The  statistics  of  the  operations  of  the  Health  Department, 
herewith  presented  for  your  consideration,  will  be  found  highly 
interesting,  as  exhibits  of  the  work  done  during  the  past  year. 
These  comprise.  Tables,  showing  the  number  of  cases  treated, 
and  Deaths  in  each  Health  District  and  Hospital,  during  each 
month  and  the  year,  with  a  classification  of  Age,  Sex  and  Status, 
the  number  and  kind  of  surgical  operations,  and  the  diseases 
treated  in  the  Health  Department,  during  each  month  and  the 
year,  with  the  number  of  deaths  from  each  disease;  and  the 
Reports  of  the  Health  District  Physicians  upon  the  Sanitary 
condition  of  the  Districts  of  the  City,  of  which  they  have  had 
charge  during  the  same  period. 

The  Health  Department  bas  now  been  in  operation  during 
two  years,  and  the  United  States  Government  has  continued  to 
furnish  all  the  Medical  and  Hospital  Supplies  used  for  the  treat- 
ment of  the  poor  of  the  City,  of  all  classes,  both  in  Hospital  and 
at  the  Dispensaries,  together  with  Rations  for  the  Hospitals, 
Fuel,  Transportation,  &c,  in  accordance  with  the  agreement 


4 

between  the  Surgeon  in  Chief  of  the  Bureau,  R.  F.  and  A.  L., 
and  the  City  Council,  in  December,  1865. 

The  advantages  to  the  City  of  this  arrangement,  have  been 
obviously  great,  as  the  City  lias  been  saved  a  large  outlay  for 
the  articles  so  supplied. 

The  following  is  a  summary  of  the  Cases  treated  and  Deaths: 

Total  number  of  Cases  treated  in  the  Department  dur- 
ing the  year  1867,  all  classes  11,116 

Of  this  number  (4,803)  four  thousand  eight  hundred  and 
three  were  Whites;  and  (6,313)  six  thousand  three 
hundred  and  thirteen  were  Blacks  and  Colored,  as  fol- 
lows : 

In  the  City  Hospital,  Mazyck  St.,  Whites,  180,  Blacks  &  Col'd,  G80 


"  Hampstcad,       "       300,      "  «  8 

"     Small  Pox  Hospital,  "  0,      "  3 

"      Six  Health  Districts,  "     4,314,      »  »  5,622 


Totals,  4.803  (5,313 

Grand  Total,  11,116 

Total  number  of  Deaths  in  the  Department  during  the 

year  1867,  all  classes   371 


Of  this  number,  (89)  eighty-nine  were  Whites,  and  (282) 
two  hundred  and  eighty-two  were  Blacks  and  Colored, 
as  follows : 

In  the  City  Hospital,  Mazyck  St.,  Whites,  12,  Blacks  &  Col'd,  120 


'<            »             Hampstcad,  "        16,  "        «     "  1 

"      Six  Health  Districts,  «        61,  "  "  161 

Totals,  89  282 
Grand  Total,  371 


The  Total  number  of  Prescriptions  prepared  and  administered 
in  the  Department,  during  the  year,  was  about  (56,400)  fifty- 
six  thousand  four  hundred. 

Respectfully  submitted, 

GEOEGE  S.  PELZER,  M.D., 

City  Registrar. 


W  II I  T  E  S  . 


DISEASES. 
CLASS  No.  1. 

/jinixQiic  Jjiseascs. 

u 

February.  j| 

March. 

April. 

May.  || 

June. 

July. 

August. 
September.  | 

October. 

November. 

December. 

1 

2 

'*5 

"2 

*2 
1 

2 
2 
2 
2 
2 
5 

1 
1 
1 
1 

2 

1 

*2 

1 

3 

*2 

2 

2 

15 
4 

20 
8 

10 
2 
4 
2 
5 

22 
I 
1 
1 
6 
1 
4 

11 
2 

1 
1 
1 
4 
1 
4 
1 
8 
8 
1 
14 
1 
i 

12 
10 
3 
1 
22 
4 
3 
1 
2 

7 
2 
2 

3 
3 

1 

2 
1 

1 

1 

1 

1 

1 

1 

1 

1 

3 
7 
1 

"4 

i 

3 

2 

1 

1 
1 
1 

1 

2 

2 

2 
1 

2 
i 

"3 

1 
1 

2 
1 

1 
1 

1 

CLASS  No.  2. 

Diseases  of  a  General  or  uncertain  Scat, 

1 

1 

1 

1 

1 

1 

*i 

1 

1 

1 

1 

1 

1 

3 
1 

■  1 

2 

1 
1 

"i 

"1 

1 
1 

i 

i 

al  9 

1 

3 

3 

1 

1 

".3 

CLASS  No.  3. 

Diseases  of  the  Nervous  System. 

1 
2 

1 

"i 

2 

"l 

2 
1 

1 
1 

6 

4 

"i 

"2 
1 

"2 

"i 
3 
1 

1 
1 

'  1 

1 

3 
1 

"2 

1 

"2 
"2 

1 

"i 

1 

1 

1 

1 

6 


W  11  1  T  E  8  . 


DISEASES. 
CLASS  No.  3— Continued. 

1  January.  1 

February. 

|  March.  || 

April. 

May. 

June. 

i-: 

August. 

Z 

£ 

October.  || 

November.] 

December. 

Totals.  II 

1 

i 
l 

1 

1 
4 
1 
1 
1 
Hi 

1 

3 
2 
i 

1 

1 

i 

...I... 

1 

2 

1 

3 

1 

2 

2 

4 

2 

CLASS  No.  4, 

Diseases  of  the  Respiratory  System. 

1 

2 

1 

i 

1 

7 

5 

2 

3 

5 

2 

1 

4 

4 
1 

4 
1 

2 

5  44 
...  2 
i !  i 

1 

i 

1 

i 

5 
2 
9 
1 

13 
1 
1 

1 

8 
1 
1 

3 

1 

6 
4 
7 
4 
2 

i 

i 

1 

1 

1 

i 

2 

1 

1 

4 

1 

V 

5 

2 

3 

1 

1 

1 

1 

CLASS  No.  5. 

Diseases  of  the  Circulatory  System. 

1 
2 

i 

1 

1 

.... 

1 

1 
1 

1 
1 

1 
1 



1 

1 

CLASS  No.  6. 

Diseases  of  the  Digestive  System. 

■ 

2 

2 

1 
1 

2 

i  L. 

2 

1 

1 

1 
1 

2 

2 

2 

i-7 

VV  I  I I  T  E  S 


DISEASES. 

PJ.ASS  Nn  R — finntinued. 

January. 

M 

99 

Ih 

X> 

<D 
ft 

March. 

April. 

May. 

June. 

1  July- 

[  August.  1 

September. 

October. 

November. 

December. 

1 

...I... 

1 

"i 

1 

1 

t  •                    J    /nr^       „  i    „   /  ^  •  1»—  — 

1 
J 

1 

1 

Stomach  and  Intestines,  Aphthus  Ul- 

1 

l 

1 

3 

2 

'2 

3 
2 

....  1 

CLASS  No,  7. 

Diseases  of  the  Urinary  System. 

1 

i 

1 
1 

1 

IT) 

1 

CLASS  No.  8. 

Diseases  of  the  Generative  System. 

Cancer  Uteri  

2 

1 

l 

1 

1 

1 

1 

1 

Peritonitis,  Puerperal  

1 

1 

1 

1 

CLASS  No.  10. 

Diseases  of  the  Locomotive  System. 

1 

CLASS  No.  11. 

External  Causes. 

1 

j 
1 

WHITES. 


u 

DISEASES. 

CLASS  Nn  11--Continued. 

anuary. 

ebruar 

[arch. 

pril. 

une. 

ugust. 

3ptemb< 

ctober. 

ovemb( 

>ecemb( 

OTAL. 

*^ 

* 

C 

£< 

H 

1 

1 

1 

2 

1 

4 

1 

1 

1 

/ 

4 

1 

1 

CLASS  No.  12. 

.... 

3 

1 

1 

2 

1 

1 

1 

2 

12 

CLASS  No.  13. 

1 

1 

CLASS  No.  14. 

1 

1 

1 

2 

1 

1 

3 

4 

2 

1 

1 

1G 

84 

2G 

23 

30 

48 

36 

45 

G8 

47 

4G 

29 

30 

462 

9 

BLACKS  AND  COLORED 


DISEAS  E  S. 


CLASS  No,  1. 


Zymotic  Diseases. 

Chill,  Congestive  

( Miolera  Infantum  

Cholera  Morbus  

Diarrhoea  

Diphtheria  

Dysentery  

Erysipelas  

Fever,  Bilious  

Fever,  Bilious  Eemittent.... 

Fever,  Congestive  

Fever,  Enteric  

Fever,  Infantile  Remittent. 

Fever,  Intermittent  

Fever,  Pernicious  

Fever,  Remittent  

Fever,  Typhoid  

Fever,  Typhus  

Hooping  Cough  

Pyaemia  

Syphilis  


CLASS  No,  2, 

Diseases  of  a  General  or  Uncertain  Seat. 


Atrophy  

Cancer  

Debility  

Dropsy  

Dropsy  from  Heart  Disease.... 
Dropsy  from  Hepatic  Disease. 

Gangrene  

Hemorrhage  

Marasmus  

Melanaemia  

Scrofula  

Scurvy  

Tuberculosis  

Tumor  


CLASS  No.  3. 

Diseases  of  the  Nervous  System, 

Apoplexy  

Brain,  Disease  of.  

Cerebritis  

Convulsions  

Epilepsy  

Hydrocephalus  

2 


1  ... 


1  2 

Z\"i 

2  1 

If... 
H  1 


10 


12 


1  1 
..  1 


2 

oi  2 
1  1 
4  1 


10 

BLACKS  AND  COLO E ED. 


DISEASES. 
CLASS  No,  3-Continued. 


Insanity  

Meningitis  

Nervous  Prostration. 

Paralysis  

Tetanus  

Trismus  Nascentium. 


CLASS  No.  4. 

Diseases  of  the  Respiratory  System. 


Asthma  

Bronchitis  

Consumption  

Croup  

Hydrothorax...  

Laryngitis  

Lungs,  Congestion  of.. 

Lungs,  Disease  of  

Pneumonia  

Pneumonia,  Typhoid.. 


CLASS  No.  5. 


Diseases  of  the  Circulatory  System. 


Anaemia  

Carditis,  Rheumatic  

Cyanosis  

Empyema  

Heart,  Disease  of  

Heart,  Dropsy  of  

Heart,  Hypertrophy  of  

Heart,  Valvular,  Disease  of. 
Hemorrhage,  Umbilical  


E5  U2 

4k 


CLASS  No.  6. 

Diseases  of  the  Digestive  System. 


Abscess,  Retro  Pharyngeal. 

Ascites  

Bowels,  Inflammation  of.... 

Colic  , 

Enteritis  

Gastritis  

Gastro  Enteritis  

Hsematemesis  

Hepatitis  

Indigestion  


1  ... 
..  2 


11 


12 


1  1 


2  2 
1 


1  .... 

1  ■ 


1  ... 


1  ...  .... 


1  ... 

lL,  . 


.1  1 


11 

BLACKS   AND   CO LOU ED 


DISEASES. 


GLASS  No,  6— Continued, 


Jaundice  

Mesenteric  (Hands,  Disease  of. 

Perineum,  Ulceration  of.  

Peritonitis  

Stomach,  Cancer  of  

Tabes  Mesenteric®  

Teething  

Thrush.'.  

Worms  


CLASS  No.  7. 

Diseases  of  the  Urinary  System. 
Kidneys,  Brights  Disease  of.  

CLASS  No,  8, 

Diseases  of  the  Generative  System. 


Birth,  Premature  

Cancer  Uteri  

Child  Bed  

Convulsions,  Puerperal. 

Fever,  Puerperal  

Hemorrhage,  Puerperal. 
Hemorrhage,  Uterine — 

Metritis  

Ovaries,  Disease  of  

Uterus,  Disease  of  


CLASS  No.  10. 

Diseases  of  the  Locomotive  System. 
Rheumatism  


CLASS  No.  11. 

External  Causes. 


Accident  

Asphyxia  

Coup  de  Soleil  

Drowning  

Execution  of  sentence 

Exposure  

Intemperance  , 

Neglect  

Suicide  

Wound,  Lacerated.... 


2 


•  rO 

a  a 


1  1 


± 

...... 


5 

1 

2 

3 

1 

1 

2 

1 

i 

10 

1 

12 

BLACKS  AND  COLORED. 


DISEASES. 
CLASS  No.  12. 


Old  Ago. 


CLASS  No.  13. 


Unknown  . 


CLASS  No.  14. 

Inanition  and  Want  of  Vitality.. 

Imperfect  Development  

Overlaid  

"Want  of  Maternal  Nourishment. 

Totals  


as  n 


*  IS  I* 


°  a 

|kl  l  I  t 


71  53  62 


65 


77 


K2 


21  9 


2  ... 


2  ... 


4  1 


841103  79  79  70  54  879 


:;  4-". 


1  5 


22 
1 

„.i  i 


13 


ilumbfr  oi  §tntUt  with  &p#,  in  mix  gfoiitfc,  and 

t\xt  far. 

WHITES. 


AGES. 


I  -I  111 

-r  &«  ~-  < 


£3  1  s 


3  i 

<         f   &  - 


Under    1  year . 

I  to  5  years 

5  to  10  years 

10  to  20  years 

20  to  80  years 

30  to  40  years 

40  to  50  years 

50  to  GO  years 

00  to  70  years 

70  to  80  years 

80  to  90  years 

«J0  to  100  rears 

Over  100  years 

Totals, — 
Total... 


34  26 


23 


22  12 

8 


2 1 
31 

i 

2 

2 
2 

0  0 
0  0 


30  48  3G 

I  I 


15  8 
9  4 


2 
7 

9 
6  7 

5  G 


14'  G 

6|  7 

0  1 

3!  0 

3  8 

7  0 

5  3 
2 

K 


45  Os 


47,46 


o 
1 
1 
0 
0  0 


29  30 


124 
61 
14 
17 
45 
42 
43 
44 
34 
24 
14 
0 
0 


462 


BLACKS   AND  COLORED. 


AGES. 


1  year.. 
5  years., 
10  years. 
20  years. 
30  years . 
40  years 
50  years. 
60  years. 
70  years. 
80  years. 
90  years. 
90  to  100  years. 
Over  100  years 


Under 
1  to 
5  to 
10  to 
20  to 
30  to 
40  to 
50  to 
60  to 
70  to 
80  to 


Totals  .. 
Total. 


January. 

[February. 

March. 
April. 

[June. 

1 

1  . 
.11 

£w 

— 

a 

© 

( October, 

November. 

December. 

Total. 

24(24 

21  24 

27 

28 

19 

24 

22 

19 

23 

11 

261 

1 

2 

0  2 

7 

16 

19 

9 

12 

6 

5 

101 

1 

0 

s 

0 

1 

3 

1 

5 

1 

2 

3 

1 

20 

3 

1 

5 

6 

2 

6 

11 

4 

7 

3 

57 

7 

3 

? 

8 

10 

13 

11 

12 

11 

9 

8 

0 

106 

4 

4 

8 

5 

7 

5 

6 

7 

4 

6 

68 

3 

2 

2  3 

3 

3 

8 

12 

5 

2 

3 

3 

49 

8 

5 

4 

2 

5 

4 

1 

1 

4 

8 

5 

3 

8 

50 

5 

4 

6 

6 

5 

G 

4 

6 

7 

5 

3 

65 

9 

3 

G 

5 

5 

2 

4 

2 

5 

5 

2 

7 

55 

4 

4 

3 

1 

1 

2 

1 

4 

1 

5 

3 

1 

30 

2 

1 

1 

1 

2 

1 

0 

2 

1 

1 

2 

0 

14 

0 

0 

1 

0 

0 

0 

0 

0 

0 

1 

1 

0 

8 

71 

53 

02 

65 

77 

82  84 

103 

70 

[79 

TO 

54 

1 

1 

879 

RECAPITULATION. 

 o  

(Total  numbfr  t»f  §!*Jrtftg  Anting  the  % m. 


CLASSES. 

Male  Whites  257 

Female  Whites  205 


Total  Whites   462 

Male  Blacks  and  Colored  423 

Female  Blacks  and  Colored  456 


Total  Blacks  and  Colored   879 


Grand  total   1,341 


NATIVITIES. 

Natives  of  Charleston,   1)13 

Natives  of  South  Carolina   249 

Natives  of  the  United  States  ,   60 

Foreigners   119 

Total   1,341 

Proportional  Mortality  to  population  1  in  26,099 

The  entire  population  being  estimated  at  35.000 


Respectfully  submitted, 

GEOEGE  s.  pelzer,  m,  jd., 

City  Registrar. 


METEORLOGICAL  ABSTRACT  of  the  Barometer,  Thermometer,  Due  Point,  Winds  and  Weather,  at  Charleston,  S.  C,  for  the  Year  ending  December  31st,  1867. 

By  GEORGE  S.  PELZER.   M.   I  >.,  City  Registrar. 


Months. 

Barometer. 

Thermometer 
Attached. 

HOTTEST  DAY. 

COLDEST  DAY. 

Thermomett 

Mean  Tcmpure. 

r  Detached. 

Max'm.j  Min'm. 

Register 
Thermom'r. 

Dew 

Point 



Course  of  Winds  at 
Sunrise. 

g 

? 
? 

Course  of  Winds  at 
4  P.  M. 

g 

w 

pq 

Weather 

Quantity 
of  Rain. 

Prevailing  Weather. 

1867. 

B 

g 

1 

« 

< 

a 

Mean,  2  p.  M. 

• 

2 

a> 
c" 

S) 

•k 

l- 

ea 

a 

ts Is  s  a  Is 

i-  |m  |oi  Jt-  |e4 

- 

% 

|  Mean  Day. 

S 

S 

CO 

to 
j£ 

0 
09 

W 

1  Northeast. 

| 

o 

X 

i 
t» 

i 

o 

X 

3 
H 

i 

£ 

o 

-~ 

« 

j 
J 
| 

January  

30.468 

29.620 

.848 

4261 

48.90 

47.29 

14th 

18th 

19.19 

17.29 

J6  LLL 

40.16 

50.13 

10 

16 

17 

0 

N  W 

15 

0 

3 

8 

22 

0 

20 

6 

5 

Pair. 

30.794 

29.0.30 

1.164 

.')4.2r) 

61.21 

58.50 

24th 

10th 

62.1  1 

51.10 

1 

4 

n.e' 

2  IS 

5 

9 

G 

26 

5 

13 

8 

7 

2!60 
6.59 

Fair. 

February  

March  

30.360 

29.850 

.510 

59.48 

57.29 

13th 

16th 

51.03 

11 

0 

N.  E. 

0  29 

6 

2 

24 

5 

0 

N.  E. 

15 

7 

9 

Pair. 
Pair. 

April  

30.436 

29.824 

612 

09.73 

24th 

13th 

0 

N.  W. 

4 

7 

9 

11 

12 

20 

8 

0 

S.  W. 

19 

5 

6 

2.08 

May  

30370 

29.404 

71. 9i; 

6 

N.  K. 

2 

11 

15 

11 

10 

23 

7 

0 

S.  W. 

4 

5 

4.16 

Pair. 

Juno  

30.362 

29.810 

77.40 

N.  B.  .t  K. 

0 

14 

5 

2 

8 

31 

in 

0 

S.  W. 

1  1 

5 

11 

13.22 

Pair. 

.Inly  

30.364 

30.06 1 

"••'iH 

16 

N.E.S.ftW. 

0 

15 

o  16 

4 

36 

6 

o 

S.  W. 

20 

5 

6 

4.93 

August  

::n  :;:>ii 

29.98(1 

.304 

12 

14 

in 

E. 

o 

3 

4 

o 

8 

11 

6 

S.  W. 

16 

8 

7 

9.89 

Pair. 

September  

30.446 

29.88s 

14 

2 

E. 

2 

11 

3 

5 

5 

9 

34 

2 

E. 

17 

7 

6 

4.58 

Pair. 

1 30.451 

29.870 

.580 

71  II 

14 

2 

N.  E. 

0 

39 

20 

0 

0 

12 

2 

0 

N.  E. 

25 

4 

5.62 

Fair. 

November....!!!! 

30.548 

29.934 

.614 

r>6.7o 

50. 00 

65.(16 

59.93 

71  75  69  42  50 

54.40 

65.06 

1 

1  1 

0 

4 

15 

6 

N.  E. 

6 

28 

10 

0 

4 

17 

9 

0 

N.  E. 

20 

* 

2 

1.30 

Fair. 

December  

||  30.472 

29.628 

.844 

50.06 

53.  l.") 

14lh 

50.  Kij  58.35 

5::. 29 

63,71  65  32  43 

47.67 

5S.5  1 

l;Y35 

14,14 

12 

2 

2 

20 

2 

0 

S.  VV. 

15 

is 

0 

2 

34 

3 

0 

S.  W. 

20 

7 

4 

2.20 

Fair, 

GEORGE  S.  PELZER,  M.D.,  City  Registrar. 


ANNUAL  REPORT 

OF  THE 

HEALTH  DEPARTMENT, 

For  the  Year  ending  on  the  31st  clay  of  December,  1867. 

Showing  the  number  of  Cases  Treated,  and  Deaths,  in  each 
Health  District,  Hospital,  and  the  Health  Department, 
during  each  Month,  with  Status  as  to  color,  Sex, 
of  each  Case,  and  the  total  number  of  Cases 
treated,  and  Deaths,  in  each  Health  Dis- 
trict, Hospital,  and  the  Health  De- 
partment, during  the  Year, 
etc.,  etc. 


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Annual  ilcport  of  f  Mjj  putrid  gto.  3. 

Charleston,  S.  C.  April  15th,  1868. 
7b  Dr.  Geo.  8.  Pelzer,  City  Registrar. 

Dear  Sir: — In  reply  to  your  several  inquiries  concerning  cer- 
tain hygienic  conditions  relating  to  the  Health  District  of  winch 
1  have  had  charge  for  the  past  two  years,  I  would  remark  first. 
Upon  the  statistical  evidence  furnished  by  the  Register  of  my 
office.  By  comparison  of  the  past  with  the  previous  year  of  1866, 
it  appears  that  the  number  of  patients  registered,  is  nearly  one- 
fourth  greater  for  the  year  ending  December  31st,  1867.  From 
general  observation,  and  the  mortuary  reports  of  the  City  Regis- 
trar, it  must  be  conceded,  that  the  health  of  the  city  was  certainly 
no  worse — if  it  was  not  very  much  better,  than  in  past  years, 
and  therefore,  we  must  look  to  some  other  sources  for  the  cause 
of  this  increase  on  our  dispensaries.  With  regard  to  the  whites, 
they  are  but  a  little  in  excess  of  the  previous  year,  and  this 
might  naturally  have  been  inferred,  from  the  fact,  that  there  has 
been  no  imigration,  and  consequently  no  foreigners  to  be  acclim- 
atized. The  freedmen  who  have  nocked  from  the  surrounding 
country,  have  gradually  driven  that  class  of  persons  who  form- 
erly occupied  them,  from  those  low,  filthy  and  insalubrious 
portions  of  the  city,  which  was  always  a  favorable  nidus  for 
epidemics,  and  a  fertile  source  of  innumerable  diseases;  and  we 
find  them  now  occupying  more  healthful  situations,  with  more 
room}'  and  comfortable  habitations,  generally  pursuing  some 
occupation,  sufficient  to  afford  them  at  least,  the  necessaries  of 
life. 

With  the  freedmen,  man}'  causes  have  combined  to  increase 
their  number.  In  the  early  part  of  1866,  the  Health  Depart- 
ment was  in  its  infancy,  and  had  not  reached  the  perfection  of 
its  present  operations;  its  very  existence  was  unknown  to  them 
for  many  months,  and  consequently,  we  were  often  not  called 
upon  by  them,  when  most  needed.  At  present,  the  length  and 
breadth  of  each  Health  District,  is  known  to  the  fraction  of  an 
inch,  and  all  its  workings  in  its  minutest  ramifications  more 
familiar  to  them  than  their  prayers.     The  earliest  accents 


62 


infant  tongues  arc  taught  to  lisp,  is  the  "Poor  Doctor's  '  name, 
and  their  tottering  steps  are  trained  toward  the  fountains, 
whence  they  hope  forever  to  draw  their  Paregoric  and  Castor 
Oil. 

The  spasmodic  efforts  at  a  new  life  of  a  disorganized  and 
ruined  commerce,  gave  temporary  employment  at  this  time,  to 
a  large  laboring  class,  and  together  with  the  large  amounts  of 
money  paid  to  disbanded  troops,  which  was  immediately  dis- 
tributed among  the  freedmen,  enabled  them  in  most  cases,  to 
procure  their  medicine,  and  pay  for  medical  attendance. 

The  Medical  profession  at  large,  had  not  yet  been  through 
the  bitter  school  of  experience,  and  been  taught  what  a  princi- 
pled disregard  the  free  dm  an  has  for  Doctor's  bills  when  he  is 
well,  however  faithfully  he  may  have  promised  when  suffering 
trom  disease,  and  now  (with  rare  exceptions,)  they  cannot  pro- 
cure the  services  of  a  Physician  with  any  claims  to  respectabili- 
ty, except  in  most  urgent  cases,  consequently,  they  are  univer- 
sally driven  to  the  dispensaries.  Unquestionably  however, 
pauperism  will  continue  to  increase;  the  successive  failure  of 
the  planting  interests,  the  disregard  of  contracts  and  moral 
obligations,  the  absence  of  foresight  and  forethought  to  impress 
upon  them  the  necessity  of  continuous  application;  their  natu- 
rally prodigal  and  improvident  nature,  and  their  restless  migra- 
tory habits,  has  impoverished  and  rendered  homeless,  many 
hundreds,  who  have  herded  hither,  where  already  the  amount 
of  laborers  are  far  in  excess  of  the  demand;  the  result  is,  that 
the  majority  of  them  cannot  procure  (even  if  so  disposed.)  em- 
ployment sufficiently  continuous  or  remunerative  to  do  more 
than  furnish  them  a  bare  subsistence  while  in  health,  when  sick 
they  suffer  for  the  absolute  necessaries  of  life,  and  though  the 
Hospitals  are  ample  and  ready  to  provide  for  them,  yet  so  gen- 
eral is  their  superstitious  aversion  to  them,  that  the  greater 
portion  prefer  to  endure  their  discomfort,  neglect  and  want,  at 
home,  rather  than  be  cared  for  there.  Could  any  system  be 
devised  by  which  the  sick  would  be  enabled  to  draw  from  the 
Hospitals  daily,  such  suitable  diet  as  might  be  prescribed  by  the 
attending  Health  Physicians,,  it  would  no  doubt  relieve  the  Hos- 
pital of  many  of  its  inmates,  be  not  more  expensive  to  the  city, 
and  alleviate  much  of  the  suffering  which  now  exists.  The 
most  stringent  ••  vagrant  laws  "  should  also  be  enforced,  with  a 


»;:; 


view  to  driving  the  unemployed  back  to  the  country,  where 
alone  it  is  possible  for  them  to  make  a  support  or  be  otherwise 
than  consumers  and  non-producers  of  society. 

Another  cause  of  the  large  numbers  on  our  dispensaries 
exists  in  the  impossibility  of  clearly  defining  who  is  and  who  is 
not  properly  entitled  to  its  benefits  ;  and  tho  anomalous  position 
we  occupy  of  serving  two  masters — the  City  as  representing 
one,  and  the  Freedman's  Bureau  the  other. 

The  freedmen  having  been  clothed  and  fed  and  educated  for 
the  last  three  or  four  years  to  the  belief  that  he  is  the  especial 
ward  of  the  Government,  very  naturally  imagines  that  his  color 
alone  entitles  him,  without  question  as  to  his  necessities,  capa- 
cities, or  pecuniary  condition,  to  the  unrestricted  services  of 
what  he  denominates  as  the  "  Poor,"  the  '-State,"  or  "Spensary" 
Doctor,  and  to  an  unlimited  supply  of  any  and  every  kind  of 
medicine  which  he  desires,  and  I  feel  convinced  that  all  of  the 
Health  Physicians  for  fear  of  being  accused  of  negligence  in 
their  duties,  (especially  to  this  favored  class,)  have  rather  erred 
on  the  other  side,  and  been  much  too  ready  with  their  services, 
and  much  too  liberal  with  the  government  medicines;  for  these 
reasons  we  have  had  with  very  rare  exceptions,  (and  these  in- 
variably on  the  most  unjustifiable  grounds,)  little  or  no  com- 
plaint made  against  us.  It  is  certain,  that  just  so  long  as  medi- 
cine and  the  services  of  a  Physician  can  be  indiscriminately 
obtained  merely  for  the  asking,  just  so  long  will  we  have  large 
dispensary  lists.  It  certainly  would  be  as  well  to  require  appli- 
cants to  be  endorsed  by  the  Alderman  of  their  respective  wards, 
or  some  other  responsible  person,  (as  is  done  with  all  other 
public  charities,)  as  throw  the  entire  onus  upon  the  Physician. 

Public  Hygiene. — I  know  not  that  this  has  been  influenced 
specially,  (at  least  in  my  District,)  by  any  particular  system  of 
art  or  science,  and  if  it  has  proved  better,  (as  I  believe  it  has 
done,)  than  in  past  years,  it  can  as  readily  be  accounted  for 
upon  the  fortuitous  circumstances  of  climactic  changes,  as  upon 
any  hypothesis  of  an  acquired  or  artificial  nature.  Our  very 
efficient  City  Surveyor,  and  energetic  Mayor,  appear  to  have 
recognized  in  the  last  few  weeks,  the  imperative  necessity  of 
certain  improvements  in  my  division  of  the  city,  and  much  has 
been  done  in  the  way  of  drainage  filling,  &c;  much  more  re- 
mains in  particular  locations,  (which  I  shall  point  out  under  the 


04 


head  of  ••  Habitations/')  which  is  quite  susceptible  of  improve- 
ment also,  and  which  1  hope  will  receive  the  consideration  of 
I  hose  whose  especial  duty  it  is  to  take  cognisance  of  these  mat- 
ters. The  universally  acknowledged  benefits  to  be  derived 
from  a  scrupulous  cleanliness  of  the  streets  as  well  as  private 
habitations  and  thorough  drainage  of  vacant  lots  and  cellars, 
need  not  be  impressed  upon  those  concerned;  how  far  this  can 
practically  be  carried  out,  remains  to  be  seen.  No  doubt  the 
entire  portion  of  the  city  lying  between  Laurens  and  Calhoun 
Streets,  and  east  of  the  Bay,  has  been  much  neglected  for  many 
years,  indeed  it  does  not  appear  ever  to  have  had  any  very  effec- 
tive efforts  made  for  its  hygienic  improvement,  and  the  wonder 
is  not  that  there  arc  so  many  sick  in  this  locality,  but  rather 
that  there  should  be  any  who  are  well. 

Private  Hygiene — Is  a  matter  that  so  little  disturbs  the 
mind  of  this  class  of  people,  that  it  were  scarcely  worth  while 
to  remark  upon  it.  Poverty  and  filth,  always  twin  sisters,  with 
them  are  synonymous,  and  doubtless  very  favorable  to  the 
development  and  propagation  of  disease.  It  is  sufficient  to  say, 
that  their  personal  hygienic  condition  is  almost  invariably  essen- 
tially bad,  but  how  and  where  the  remedy  is  to  be  applied  I 
regret  to  say  I  am  at  a  loss  to  suggest. 

Dwellings. — Possibly  the  majority  of  the  habitations  of  these 
people  are  sufficiently  roomy,  dry,  and  well  enough  ventilated  : 
a  very  considerable  portion,  however,  are  perfectly  execrable. 
In  certain  parts  of  Laurens,  Washington,  Marsh,  Concord  and 
Calhoun  Streets,  the  lots  are  below  tide  water  level  and  the 
streets  around  ;  inundated  by  every  showier  and  spring  tide,  and 
a  receptacle  for  all  the  debris  from  surrounding  yards,  they  are 
almost  always  in  a  slough,  and  in  warm  weather,  emit  the  most 
disgusting  and  offensive  odors  ;  upon  these  arc  crowded  small, 
ill  ventilated,  filthy,  dilapidated  hovels,  the  basement  floors  of 
many  of  which  1  have  seen  floating  or  submerged  by  the  rains 
or  tide  for  weeks  at  a  time.  Formerly,  these  were  occupied  by 
the  lower  classes  of  foreigners,  and  were  always  the  dens  of  vice 
and  depravity,  and  fertile  sources  of  disease;  the  gradual  en- 
croachments of  the  freedmen  have  entirely  displaced  the  original 
occupants,  who  are  no  doubt  vastly  benefitted  by  the  change, 
w  hile  they  in  a  measure  have  fallen  heirs  to  their  many  misfor- 


65 


tunes.  Into  these  places  the  freedmen  crowd  in  incalculable 
numbers.  I  have  not  infrequently  seen  ten  or  twelve  grown 
persons  of  both  sexes,  occupying  a  single  room  not  more  than 
ten  or  twelve  feet  square.  How  it  is  that  Diarrhoea.  Dysentery, 
Typhoid  Fever,  Cholera,  and  all  the  zymotic  diseases  that  flesh  is 
heir  to,  has  not  prevailed  here  and  swept  them  all  away,  is  only 
explicable  on  the  fact  that  such  is  the  peculiar  strength  of  the 
vital  principle  in  their  physiological  organism,  and  the  total 
absence  of  those  psycological  influences  which  have  so  important 
a  bearing  in  the  development  of  disease  in  the  higher  classes, 
that  it  is  only  when  extraneous  causes  of  disease  are  acting  with 
extremcst  intensity,  and  for  very  continuous  periods,  that  they 
appear  at  all  to  be  affected  by  them,  and  these  causes  are  con- 
stantly counterbalanced  by  their  restless  and  changeable  habits, 
seldom  or  ever  remaining  in  one  place  longer  than  a  month  or 
six  weeks.  Where  all  is  so  bad,  it  is  hard  to  make  any  special 
distinction,  but  I  would  here  take  occasion  to  call  attention 
more  particularly  to  lots  corner  of  Washington  and  Laurens 
Streets.  No.  10  Washington  Street,  No.  14  Washington,  "Peney's 
Row,"  Vernon  Street,  No.  6  Marsh  Street,  all  the  lower  part  of 
Concord  Street,  several  lots  directly  opposite  Anson  Street  in 
Calhoun  Street,  and  various  others  lying  between  this  and 
Washington  Street,  on  the  north  side  of  Calhoun.  Lots  on  the 
north  side  of  Chapel  Street,  between  Elizabeth  and  Alexander, 
and  also  on  the  east  side  of  Alexander  near  Chapel  Street.  In- 
spection Street,  on  both  sides  between  Washington  and  Marsh, 
Wharf  Street,  almost  throughout  its  entire  length,  and  various 
others  of  minor  import  in  the  same  vicinity. 

Food. — This  is  ordinarily  of  the  simplest  and  coarsest  nature, 
wheat  bread,  corn  meal,  fish,  and  occasionally  a  little  bacon, 
forming  the  staple  articles.  Fish,  both  salt  and  fresh,  supplies 
almost  exclusively  (from  their  natural  fondness  for  it  and  its 
comparative  cheapness)  the  place  of  all  other  azotized  substan- 
ces, and  when  fresh,  being  of  an  easily  digestible  and  nourishing 
character,  is  a  very  excellent  and  suitable  form  of  diet,  seldom 
or  ever  becoming  a  cause  of  disease  except  when  used  in  an 
unsound  state,  and  even  then,  causing  seldom  more  than  a  tem- 
porary indisposition. 

Occupations. — With  them,  as  a  mass,  occupation  is  so  infre- 
quent and  multifarious,  that  it  can  have  no  possible  influence 
9 


upon  their  discuses;  they  do  not,  with  but  extremely  rare  excep- 
tions, pursue  any  arts  or  trades  as  a  business,  that  are  in  them- 
selves del  el  t  noun,  but  for  the  most  part  are  engaged  in  ordinary 
out-door  labor. and  this  usually  in  such  homoeopathic  proportions, 
as  rather  to  be  conducive  than  otherwise  to  a  perfect  state  of 
health. 

Prevalence  of  Disease. — If  we  except  intermittent  fever, 
no  particular  disease  can  properly  be  said  to  have  prevailed, 
other  than  those  incident  to  certain  seasons  of  the  year,  as 
Cholera  Infantum,  Diarrhoea,  Dysentery,  &c,  usual  in  the 
early  summer,  and  all  the  varieties  of  Pneumonic  disease  during 
the  winter  months,  interspersed  with  such  accidental  and  spo- 
radic cases  as  must  necessarily  be  anticipated  under  any  circum- 
stances, but  none  of  these  have  been  more  general,  more  serious 
or  less  amenable  to  treatment,  than  in  former  years.  Indeed, 
reference  to  my  visiting  list  shows  that  although  the  total 
number  registered  is  considerably  larger  than  last  year,  yet  the 
actual  labor  has  not  been  greater,  as  a  much  larger  proportion 
have  been  office  patients,"'  and  their  diseases  of  that  trivial, 
or  benign  character,  which  docs  not  usually  entail  any  consider- 
able amount  of  work. 

With  regard  to  the  endemic  of  Intermittent  Fever,  which  was 
so  universal  and  wide  spread,  could  any  plausible  theory  of  its 
origin  here  and  any  reasonable  propositions  for  its  prevention 
be  ottered,  it  might  well  engage  the  serious  attention  of  us  all, 
but  unfortunately,  what  the  essence  of  this  thing  which  we  call 
miasma,  is,  what  produces  it,  where  it  comes  from,  and  how  to 
counteract  its  baneful  influences,  are  questions  of  which  there 
has  been  no  certain  solution  given  yet. 

Superficial  observation  will  readily  accord  to  "burnt  districts" 
"stagnated  cisterns,"  "open  cess  pools,"  '-decaying  vegetable 
matter"  and  frequent  rains,  the  self  apparent  cause  of  these  mias- 
matic fevers,  but  let  us  inquire  if  such  an  hypothesis  is  supported 
by  facts.  The  river  Tagus  at  Lisbon,  Dr.  AVatson  informs  us, 
separates  a  healthy  from  a  most  pestiferous  district ;  on  one  side 
is  a  barren  hilly  country,  the  foundation  of  the  soil  and  the  beds 
of  the  river-courses  being  of  rock  with  tree  open  water-courses 
among  the  hills,  this  is  the  healthy  side  ;  on  the  Alentejo  land 
on  the  other  side,  being  perfectly  dry  and  sandy,  is  most  unheal- 
thy.   Moreover,  in  and  near  Lisbon  there  arc  numerous  gardens 


where  they  keep  water,  during  the  three  months  absolute 
drought  of  the  summer  season,  in  stone  reservoirs  ;  these  reser- 
voirs containing  water  in  the  most  concentrated  state  of  foul  news 
and  putridity  are  placed  close  to  the  houses  and  sleeping  rooms, 
the  inhabitants  literally  live  and  breathe  in  their  atmosphere. 
Yet  no  one  ever  heard  or  dreamt  of  lever  being  generated 
amongst  them  from  such  a  source,  though  the  most  ignorant 
native  is  well  aware  that  to  cross  the  river  and  sleep  on  the 
Alentejo  side,  where  a  particle  of  water  had  not  been  seen  for 
months  and  where  water  was  never  known  to  be  putrid,  he 
would  run  the  risk  of  being  seized  with  fever. 

In  the  Dutch  Brabant  in  Holland,  intermittent  levers  became 
epidemie  when  the  British  army  encamped  upon  its  arid  plains 
of  sand  where  no  moisture  could  exist  and  where  vegetation 
was  perfectly  extinct.  After  the  battle  of  Talavera  the  army 
retreating  along  the  course  of  the  Guadiana  river  into  the  plains 
of  Estremadura  where  the  country  was  so  dry  for  want  of  rain 
that  the  Guadiana  itself  and  all  the  smaller  streams  had,  in 
fact,  ceased  to  be  streams,  the  troops  suffered  from  remittent 
fevers  of  such  malignity  that  the  enemy  and  all  Europe  believed 
that  the  Britisb  host  was  extirpated.  At  Cividid  Bodrigo,  on 
the  rocky  bank  of  the  river  Agueda,  a  remarkably  clear  stream, 
the  country  around  which  had  become  as  hard  and  dry  as  a 
brick  ground  and  every  vestige  of  vegetation  utterly  burned  up, 
the  levers  were  only  equalled  in  malignity  to  those  of  the 
Guadiana.  Dr.  Ferguson  farther  tells  us  that  in  Spain  (unques- 
tionably one  of  the  dryest  countries  in  Europe  and  quite  as 
prolific  of  malarial  fever)  towards  the  end  of  summer  you  may 
look  in  vain  for  lakes,  marshes,  ditches,  pools  or  even  vegeta- 
tion, and  it  is  not  until  it  has  again  been  made  one  of  the 
wettest  by  the  periodical  rains,  with  its  vegetation  and  aquatic 
weeds  restored,  that  it  can  be  called  health}'  or  even  habitable 
with  any  degree  of  safety.  The  rotting  cabbage  leaves  of 
Covent  Garden  and  those  which  taint  the  air  of  the  Btreetsfrom 
the  neglected  dust  holes  of  London  during  the  hot  weather  of 
summer  give  rise  to  no  ague.  In  the  immediate,  vicinity  of  the 
Dismal  Swamp  and  in  the  lower  Bayous  of  Louisiana  teeming 
with  the  rankest  aud  most  luxurious  vegetation,  we  have  no 
intermittent  fevers,  while  the  country  around  and  the  banks  of 


68 


the  Mississippi  abound  with  it.  On  the  banks  of  the  Indian 
rivers  in  Biirmah  and  Siam  it  is  said  those  have  the  best  chances 
of  escape  from  fevers  who  live  in  houses  built  upon  piles  in  the 
water  and  only  approachable  in  boats. 

In  our  own  State  it  is  neither  those  places  situated  on  elevated 
hills  nor  in  the  valleys,  upon  the  rivers  or  away  from  them, 
those  in  the  neighborhood  of  stagnant  mill  ponds  and  marshes, 
nor  those  surrounded  by  cultivated  fields  or  barren  pine  lands, 
that  suffer  immunity,  but  here  a  village  and  there  a  town, 
regardless  of  topographical  considerations,  that  is  comparatively 
exempt  from  miasmatic  fevers,  the  causes  of  this  exemption  at 
present  are  inexplicable. 

But  to  return  to  the  city.  If  burnt  districts,  stagnant  cisterns, 
rank  vegetation,  &c,  <fcc,  had  aught  to  do  with  the  last  epidemic, 
why,  when  these  causes  have  been  in  operation  since  December, 
1861,  (date  of  the  fire)  have  we  only  witnessed  its  effects  during 
the  last  summer  ?  Up  to  this  time,  I  believe  it  will  not  be  disputed 
intermittent  fever  has  not  been  more  frequent  than  in  former 
years.  Moreover,  is  it  not  likely  that  if  these  were  the  causes 
its  effects  would  first  have  been  seen  in  and  around  these  infec- 
tious centres,  and  afterward  spreading  itself  outward  and  out- 
ward to  undefined  limits  ;  but  on  the  contrary,  these  portions  of 
the  city  were  comparatively  exempt,  at  least  until  very  late  in 
the  season  ;  the  first  mutte rings  of*  the  storm  were  heard  miles 
away  from  us,  in  the  distant  hills  and  in  the  pincy  woods,  in 
the  surrounding  islands  and  the  country  villages  where  it  was 
never  heard  or  seen  before  ;  finally,  from  the  suburbs  it  gradually 
rolled  itself  in  and  upon  us,  and  sweeping  onward  to  the  North 
passed  far  in  advance  of  its  ancient  landmarks.  Of  late  years 
many  of  the  suburban  residences  of  Philadelphia  and  neigh- 
boring cities  have  been  abandoned  in  consequence,  and  Massa- 
chusetts and  Connecticut  physicians  tell  us  of  the  gradual 
encroachment  of  Periodic  fevers  which  were  formerly  unknown 
to  them.  To  residents  of  the  city  it  may  not  be  so  apparent, 
but  by  planters  and  countrymen  it  is  very  generally  conceded 
that  the  character  of  our  seasons  have  undergone  a  very  con- 
siderable change  in  the  last  half  century.  Certain  it  is  that 
malarial  fevers  commence  earlier  are  more  general  and  more 
obstinate  now  in  the  spring  than  formerly.  A  strong  proof 
of  this  we  have  in  the  fact  derived  from  circumstantial  cvi- 


69 


dcnco  in  reading  the  histories  of  Colonial  times.  Then  and  for 
many  years  after,  planters  remained  invariably  on  their  planta- 
tions (chiefly  rice  plantations  and  generally  considered  as  most 
unhealthy)  until  the  latter  part  of  June,  and  they  returned  to 
them  in  the  early  fall  without  an  idea  of  running  any  risk  of 
malarial  fever  ;  we  know  that  at  present  it  is  thought  madness 
to  remain  even  on  the  most  salubrious  places  beyond  the  first  of 
May.  It  is  not  presumable  these  men,  fresh  from  foreign  coun- 
tries or  but  a  generation  removed,  were  less  susceptible  to  this 
disease  than  the  present  generation,  born,  raised  and  inured  to 
the  insalubrious  clime.  No  one  who  has  travelled  much  through 
the  lower  section  of  our  country  (I  doubt  not)  but  has  stopped 
at  some  fallen  gate  or  perhaps  a  solitary  gate  post,  and  as  he 
gazed  through  the  long  vista  of  overreaching  moss-covered 
oaks  and  seen  beyond  the  fallen  shutters,  the  grass-grown  roof, 
and  dilapidated  stairway  of  some  grand  old  mansion,  with  its 
decaying  outbuildings,  broken  terrace,  neglected  garden,  stagnant 
fish  pond  and  all  the  accompanying  evidences  of  departed  grand- 
eur, but  has  dropped  the  silent  tear,  or  at  least,  heaved  a  heart- 
felt sigh  as  he  wondered  where  all  was  so  lovely,  so  beautiful 
and  so  attractive  that  there  should  be  no  living  being  there  now 
to  enjoy  it  ;  sterility  of  the  soil  has  probably  occurred  to  most 
observers  as  the  most  reasonable  cause  of  its  desertion,  we  know 
the  contrary  to  be  the  fact  ;  the  lands  arc  as  productive  and 
remunerative  as  any  in  the  State,  and  in  many  cases  are  still 
cultivated  to  advantage,  but  obviously  the  length  of  term  for 
the  enjoyment  of  the  pleasures  of  plantation  life  has  been 
shortened  by  the  encroachment  of  malarial  fevers,  and  for  this 
reason  so  many  in  the  lower  and  middle  sections  of  our  State 
have  been  abandoned  and  left  to  gradual  decay.  Four  ele- 
ments alone  seem  necessary  for  the  development  of  this 
febrific  poison  :  earth,  air,  heat  and  moisture,  and  only  so  far 
as  artificial  means  can  modify  the  two  latter  may  we  hope 
to  have  any  influence  upon  its  deprecating  effects.  Time  and  the 
limits  of  this  paper  does  not  permit  me  to  pursue  this  subject 
farther,  I  have  already  transgressed  upon  both  ;  only  one  other 
remark  I  Avould  make  in  connection  with  this  subject  regarding 
the  susceptibility  of  the  negro  race  to  the  contagion  of  this 
fever  which  has  been  rather  singular  and  contrary  to  precon- 
ceived ideas  and  what  from  experience  might  reasonably  have 


To 


been  anticipated.  Born  and  raised  in  the  most  malarious 
sections  of  our  country,  laboring  under  the  burning  rays  of  the 
summer  sun  and  constantly  breathing  the  foulest  and  most 
pestiferous  atmosphere,  whose  every  zephyr  bears  the  elements 
of  d isease  and  death  to  the  white  man,  he  has  enjoyed  almost 
perfect  immunity  from  fever  and  reached  the  highest  grade  of 
physical  development  ;  but  here,  removed  to  the  city,  so  far 
from  being  exempt,  he  has  suffered  much  more  not  only  than 
the  white  man,  but  than  those  of  his  own  race  who  are  natives, 
proving,  however  strong  and  perfect  his  physical  organization 
and  power  of  resistance  to  this  noxious  element  in  fixed  loca- 
tions, his  total  inaptitude  for  any  change,  however  slight. 

in  conclusion,  my  experience  in  Dispensary  practice  (and  it 
has  not  been  a  recent  one)  leads  me  to  believe  that  too  many 
ollices  is  as  great  an  evil  as  too  few;  the  characteristic  of  human 
nature  is  the  same  in  every  department  of  life  ;  unless  tborc  is  a 
strong  motive  for  action  it  usually  lapses  into  careless  indiffer- 
ence or  total  negligence. 

The  common  dictates  of  humanity  would  make  it  appear  to  be 
imperative  that  ample  public  provision  should  be  made  to  meet 
the  misfortunes  of  those  whose  greatest  crime  is  poverty,  but 
the  question  arises,  are  the  worthy,  honest  and  industrious  poor 
commonly  the  recipients  of  this  charity  ?  In  some  cases  they  are, 
in  the  majority  they  are  not ;  it  is  the  worthless,  vagabond,  idle, 
dishonest,  improvident  drones  of  society,  who  arc  either  too 
lazy  to  earn  a  living  by  honest  labor,  or  who  squander  their 
daily  gains  in  the  pursuit  of  vice  and  debauchery,  who  crowd 
up  our  Dispensary  registers.  There  is  no  really  honest,  hard- 
working upright  person  in  the  community  who  would  not  be 
able  to  procure  the  services  of  almost  any  physician  when  their 
circumstances  were  property  represented,  and  such  upon  close 
examination  will  be  found  to  be  the  case  with  nearly  all  this 
class  of  persons.  Doubtless  many  physicians  now  throw 
patients  upon  the  Dispensary  who  would  not  otherwise  do  it 
but  from  the  fact  of  the  multiplicity  and  accessibility  of  these 
offices.  It  would  be  much  better  to  pay  a  few  trustworthy, 
efficient  officers  a  reasonable  salary,  making  the  tenure  of  office 
more  secure,  and  require  them  to  use  a  severe  discriminating 
power  towards  the  applicants  rather  than  have  a  larger  number 
who,  conscientiously  performing  their  duties,  extend  the  chari- 


71 


ties  too  far,  (fostering  a  feeling  of.general  dependence)  from  fear 
that  an  accusation  of  negligence  of  duty  might  be  brought 
against  them  if  they  refuse  the  application  of  any  one,  and 
being  unwilling  to  appear  to  receive  remuneration  for  an  insuf- 
ficiency of  work.  J  would  farther  suggest  that  the  Dispensaries 
could,  in  the  depressed  condition  of  the  city  finances,  be  readily 
made  self-supporting  by  the  requirement  of  a  merely  nominal 
registration  fee,  say  50  cents  to  be  paid  as  each  patient  is  regis- 
tered. Calculating  the  number  registered  last  year  this  would 
more  than  pay  the  salary  of  the  officers. 

Respectfully,  your  obedient  Servant, 

JOHN  L.  AKOBUM,  M  .  D, 


|tnmal  it r port  of  fealty  district  Ho.  4. 


Charleston,  S.  C,  April  15th,  1808. 

To  Dr.  (iEo.  S.  Pelzer, 

City  Registrar  and  Chief  of  the  Health  Department  : 

Doctor  ; — Your  circular  of  date  April  13th,  1868,  requesting  a 
"Sanitary  lleport,"  embracing  the  Hygeine,  public  and  private, 
of  the  Health  District  I  have  had  the  supervision  of  during  the 
past  year,  1867,  the  origin,  maintenance  and  propagation  of 
disease,  the  causes  originating  the  same,  and  the  suggestions 
remedying  the  above,  is  at  hand;  and  I  have  the  honor  to  submit 
the  following  report,  regretting  that  the  time  allowed  and  the 
circumstances  are  such  as  to  prevent  the  investigation  and  eluci- 
dation of  the  subject,  which  the  material  and  observation  at  my 
command  would  justify. 

REPOKT. 

The  vast  importance  of  a  correct  understanding  of  the  laws 
regulating  Hygiene,  the  means  of  preventing  the  origin  of 
disease,  and  its  propagation,  can  only  be  acquired  by  the  closest 
observation  and  an  intimate  and  daily  contact  with  the  effects 
resulting  from  the  operation  of  causes  which  by  the  proper 
application  of  remedies  can  prevent  the  spread  of  disease,  and 
secure,  at  least,  comparative  health  or  an  absolute  immunity 
from  malignant  and  unmanagable  complaints,  having  as  they 
always  do,  a  tendency  to  epidemic  or  edemic  propagation. 
During  the  past  year  the  Health  Physician  has  had  unusual 
facilities  for  observation,  resulting  from  the  large  increase  in  the 
number  of  patients  brought  under  his  care,  their  character  and 
customs,  habitations,  mode  of  living,  as  influenced  by  race,  occu- 
pation and  diversity  of  interest,  the  withering  effects  of  poverty 
producing  necessarily  a  lack  of  moral  restraint,  resulting  in 
debauchery  and  vice,  laying  where  numbers  are  congregated, 
the  seeds  of  disease,  and  putting  at  naught  the  means  of  cure. 
It  will  be  observed  that  our  remarks  are  predicated  upon  an 


7:; 


intiimite  knowledge  of  the  poor  and  not  of  the  rich,  whom 
instruction  and  education  prompt  to  observance  of  the  laws  of 
health,  which  only  law  and  force  can  compel  in  the  destitute. 

1  would  notice  then  1st.  The  public  hygiene  of  the  Health 
District.  2d.  The  private  hygcine.  3d.  The  character  of  the 
dwellings.  4th.  The  various  occupations  and  their  influence 
upon  the  spread  of  disease.  5th,  Particular  diseases,  their  cause 
and  origin.  Gth.  Suggestions  for  the  relief  and  prevention  of 
evils  which  would  probably  arise,  particularising  such  localities 
as  judgment  and  experience  would  dictate. 

1st.  public  hygiene. 

Having  jurisdiction  of  perhaps  the  healthiest  and  best  provided 
section  of  the  eity,  at  the  same  time  largely  populated  and 
extending  over  a  large  area,  yet  there  are  certain  sections  and 
localities  which  may  safely  be  considered  as  legitimate  subjects 
of  comment,  and  suggest  greater  vigilance  of  execution  of  the 
means  in  our  power  provided  to  prevent  the  evils  arising  from 
their  presence  in  our  midst. 

As  a  rule,  general  cleanliness  of  the  streets  has  been  observed, 
garbage  and  detrutus  from  the  yards  promptly  removed,  drains 
kept  free  of  stoppage  where  they  existed,  and  at  least,  in  outward 
appearance,  general  care  was  instituted.  It  is  particularly  to 
the  existence  of  low,  damp  and  undrained  localities,  several  of 
which  exist  in  this  district,  that  I  would  call  especial  attention. 
1st.  Among  these  is  the  section  extending  from  Cannon 
street  On  the  north  to  Badcliffe  on  the  south,  and  bounded  by 
Coming  on  the  east  and  Rutledo-e  on  the  west.  It  is  here  that 
after  each  heavy  fall  of  rain  the  water  accumulates,  and  not 
having  sufficient  draining,  remains,  saturating  the  earth  fre- 
quently for  days,  subject  to  the  influence  of  the  hot  summer 
suns,  remaining  stagnant  or  else  evaporating  so  quickly  as  to 
produce  very  serious  effects,  added  to  which,  there  being  no 
outlet  to  that  in  yards  and  cellars,  it  frequently  remains  unat- 
tended to  until,  compelled  by  the  report  of  "n  uisances ,"  steps  are 
taken  to  remedy  the  evil.  Though  there  is  sewerage  in  this 
vicinity  yet  from  the  nature  of  the  locality,  and  the  general  char- 
acter of  the  inhabitants,  it  seems  that  it  is  not  sufficient. 

It  was  in  this  section  of  the  city  that  the  burden  of  the  Health 
Physician's  labors  resided  during  the  past  summer.  Malarial 
10 


74 


fever  abounded,  attacking  indiscriminately  both  whites  and 
blades,  of  all  ages  and  sex,  originating  clearly  in  some  peculiarity 
of  locality,  and  although  the  endemic  may  have  been  considered 
general  upon  the  Neck,  yet  it  certainly  increased  in  certain 
situations,  influenced,  no  doubt,  by  causes  operating  in  a  silent 
but  sure  manner,  and  which  could  be  palliated  if  not  entirely 
remedied. 

2d.  The  section  known  as  the  Palmetto  street  lots  and  Lucas 
street  shanties,  built  upon  stilts,  the  surface  of  the  yards  below 
that  of  the  streets,  when,  upon  every  spring  tide  they  arc  sub- 
merged, no  outlet  being  secured,  no  drainage  executed,  and 
inhabited  by  large  numbers  of  negroes  and  poor  whites,  huddled 
together  and  living  in  filth.  The  water  accumulates  in  large 
quantities  and  the  earth  is  in  a  perpetual  state  of  saturation. 

3d.  Gadsden  street  and  its  vicinity  very  nearly  of  the  same 
class,  and  producing  the  same  injurious  effects.  These  are  the 
principal  sections  that  need  attention,  and  though  there  are 
others  which,  to  a  medical  eye,  could  be  improved,  yet  they  are 
not  of  a  sufficient  gravity  to  merit  attention. 

An  efficient  system  of  sewerage  by  a  well  connected  system 
of  sewers,  with  the  main  trunk  on  Coming  street,  properly  built 
with  sufficient  grade;  the  strict  enforcement  of  the  law  requiring 
the  proper  drainage  and  filling  of  private  lots,  the  elevation  of 
open  lots  above  that  of  the  streets,  with  proper  vent  to  the 
accumulated  water,  not  to  speak  of  the  commencement  of  1  lie 
initiation  of  a  system  of  paving  the  streets,  gradually  and 
efficiently  executed,  and  the  benefit  of  which,  if  the  nature  of 
this  report  permitted,  could  be  demonstrated  by  comparison  and 
hygienic  statistics,  are  the  means  which  readily  suggest  them- 
selves to  the  mind  of  the  Health  Physician  as  proper  and  expe- 
dient to  correct  the  evil. 

2d.  private  hygiene. 

Under  this  head  will  be  noticed  the  cleanliness  of  yards, 
proper  disposition  for  ventilation  and  the  procurement  of  light, 
the  disposition  of  the  contents  of  privies  and  drainage. 

Three  of  the  great  requisites  for  the  healthy  existence  of 
human  beings  are  due  supplies  of  pure  air,  light  and  water,  and 
it  is  strange  that  among  the  poor  so  little  attention  is  paid  to 
either.    In  looking  for  the  origin  of  disease  in  a  community,  it  is 


7.") 


important  that  every  possible  contingency  should  be  investi- 
gated as  from  the  accumulation  of  small  causes  are  generated 
effects  which  are  extremely  detrimental.  Among  the  colored 
population  especially  are  these  neglected.  Frequently  are  they 
found  located  in  houses  and  rooms  so  dark  as  to  require  lights 
in  the  mid-day,  no  ventilation,  improper  food  and  complete 
listless  indifference.  As  a  rule  no  attention  is  paid  to  the  above 
and  frequently  we  can  trace  serious  disease  to  this  cause. 

The  yards  of  this  class  arc  generally  kept  and  allowed  to 
remain  dirty.  Filth  accumulates  in  large  masses  around  the 
houses,  drains  are  allowed  to  he,  and  remain  stopped  up;  stag- 
nant water  settles  in  the  lots  and  yards,  and  beneath  their 
houses  ;  large  numbers  are  congregated  together,  and  with 
carelessness,  idleness  and  indifference,  there  is  laid  the  founda- 
tion of  Typhoid  Fever,  and  other  kindred  affections.  There  are 
exceptions  to  these  among  this  class,  however.  Stringent 
rules  requiring  the  closest  attention  to  the  correction  of  the 
above,  with  surety  of  punishment  for  their  non-observance, 
are  the  means  to  be  adopted  to  modify  the  evil.  I  call  the 
attention  of  the  .Registrar  to  the  principal  localities  referred 
to  by  the  above,  viz:  McBride's  Lane,  Moses'  Lots  Beau  fain 
Street,  Lots  on  Coming,  Kadcliffe,  Morris,  Palmetto,  Lucas 
and  Duncan  Streets,  and  Hargrave  Court. 

3rd,  Character  of  the  dwellings.  Sufficient  has  been  said  to 
show  that  they  arc  of  the  worst  sort  and  class.  Generally  old, 
poorly  constructed,  badty  ventilated,  needing  repairs,  and  in  some 
few  instances  completely  uninhabitable.  Among  the  better  class 
ofpoorthisis  not  the  case.  Frequently  they  are  found  provi- 
dent, industrious,  clean,  contented  and  comfortable,  and  in  neat, 
well  protected  houses.  It  would  be  impossible  to  particularise  any 
special  position  where  these  "Evils"  exist,  as  the  various  grades 
arc  so  closely  drawn  as  to  prevent  any  close  discrimination. 
It  is  to  the  crowding  in  of  large  numbers  in  small  houses,  the 
consequently  limited  space,  below  that  necessary  to  healthy 
existence,  that  I  would  note  as  a  frequent  source  of  trouble. 

This  exists  as  much  among  the  lower  class  of  whites  as  with 
the  colored.  How  it  is  to  be  corrected  we  cannot  say.  Pover- 
ty has  no  choice  in  the  selection  of  its  abode,  and  we  can  only 
wait  for  improved  educational  facilities,  and  a  keener  sense  of 
the  value  of  life  to  correct  the  evil. 


7(5 

4  th".  The  various  occupations,  and  their  influences  upon  the 
spread  of  <liaea.se. 

It  would  be  impracticable  to  delineate  at  length,  from  among 
the  vast  numbers  of  applicants  for  aid  to  this  Dispensary, 
the  various  and  multifarious  occupations  which  arc  pursued, 
as  in  a  large  number  of  cases  pauperism  and  extreme  des- 
titution are  the  rule.  The  laboring  classes,  embracing  the 
mechanic,  artizan,  and  day  laborer,  who  are  exposed  alike 
to  the  hot  suns  and  the  cold  rains;  the  poor  female,  white  and 
colored,  who  eke  out  an  existence  by  hard  and  constant  labor ; 
the  destitute,  and  those  whose  daily  return  but  affords  means 
for  the  purchase  of  bread  and  shelter,  modified  by  every  grade 
and  character  of  employment,  constitute  the  principal  occu- 
pations of  the  destitute  poor. 

It  will  be  easily  seen  how  influences,  arising  from  these  cau- 
ses, can  originate  disease.  Poorly  housed,  poorly  clad  and 
poorly  fed,  being  among  dirt  and  filth,  wearied  by  long  and 
constant  labor,  exposed  to  the  temptation  of  drinking  aleholie 
poison  to  drown  care,  and  to  all  kinds  and  conditions  of 
weather,  without  means  of  suitable  protection,  these  subjects 
arc  and  become  fit  food  for  the  spread  of  disease,  and  but  keep 
alive  a  dcliterious  poison,  which  by  the  exercise  of  a  little  caution 
and  discretion  could  be  easily  avoided. 

5th.  Particular  diseases,  their  cause  and  origin.  In  selecting 
from  the  large,  excessive  and  varied  character  of*  disease  brought 
under  the  care  of  the  Health  Physician,  it  will  be  but  necessary 
to  refer  to  but  one  class,  as  being  of  interest,  for  the  vast  major- 
ity are  of  that  nature  which  are  incidental  to  any  and  every  com- 
munity, and  which  arc  only  aggravated  by  change  of  season  and 
temperature. 

Malarial  fere)-,  as  it  existed  in  its  various  forms  in  the  year 
18G7,  and  as  coming  under  the  observation  of  the  Health 
Physician. 

There  were  treated  from  about  the  1st  of  June,  18G7,  to  the  1st 
of  January  1868,  (37G)  three  hundred  and  seventy-six  cases  of 
Malarial  fever  :  of  this  number  the  mortality  was  very  small 
not  exceeding  from  11  to  2  per  cent.  Most  of  the  cases  were 
slight,  principally  of  the  'Tertian  Type,  attacking  whites  and 
blacks  indiscriminately,  and  not  confined  to  any  particular 
locality.    Many  of  the  cases  can  be  referred  to  temporary 


sojourn  in  the  country,  or  proverbially  known  malarial  districts, 
but  the  large  majority  originated  in  the  District  and  from 
poison  emanating  from  its  midst.  It  is  impossible,  in  a  paper 
of  the  limited  nature  of  this,  to  enter  fully  into  the  discussion 
of  the  various  merits  and  arguments,  pro  and  eon  of  the 
cause  of  malaria,  its  spread  and  effects.  Limited  as  we  are,  we 
can  only  look  at  facts  and  simply  draw  our  deductions  from 
them.  In  the  months  of  May  and  June,  the  city  was  visited  by, 
perhaps,  the  largest  fall  of  rain  that  lias  occurcd  for  many  years. 
The  streets  Avere  saturated,  and  outside  of  the  main  system  of 
drainage,  the  rain  accumulated  in  large  quantities,  and  remained 
in  particularly  low  places  for  a  long  time,  undrained  and  upon  the 
surface.  Yards  were  filled,  cellars  overrun,  and  notwithstanding 
every  effort  to  effect  complete  drainage  of  the  water  it  remain- 
ed. The  hot  suns  of  the  summer  soon  dried  the  surface,  while 
beneath  it  was  still  wet.  damp  and  with  no  means  or  vent  for 
the  accumulated  water  which  necessarily  percolates  through,  to 
the  surface ;  giving  rise  to  that  noxious  confined  effluvia 
which  wc  all  feel  is  sickening,  and  detrimental  to  health.  It 
would,  perhaps,  be  outside  of  my  jurisdiction  to  speak  of  the  ex- 
tended influence  of  the  over-grown  and  sunken  lots  in  the  Burnt 
District  of  the  city,  where  decayed  vegetation  and  stagnant 
water,  added  their  quota  to  originate,  propagate  and  increase 
Malarial  poisoning.  All  of  these  causes  must  operate  to  produce 
Malaria.  It  has  been  truly  said  that  fever  lives  on  the  banks  of 
rivers,  the  borders  of  marshes,  the  edges  of  stagnant  pools,  it 
no  less  makes  itself  at  home  in  the  neighborhood  of  such  pools  and 
badly  constructed  drains,  and  takes  delight  in  the  incense  of 
gull)r  holes. 

I  am  firmly  convinced  that  it  is  to  the  operation  of  the 
causes  above  alluded  to,  that  wc  may  trace  the  existence  of  ma- 
larial fever  in  our  midst  during  the  past  season.  Other  consid- 
erations may  have  served  to  influence,  modify,  or  increase  the 
endemic,  such  as  the  character  of  the  habitations,  customs  and 
mode  of  living,  of  the  poorer  classes,  exposure,  etc.,  but  as  the 
guardians  of  the  public  health  we  must  not  loose  sight  of  the 
main  causes,  and  the  remedies  to  prevent  them.  Estimating 
from  observation  of  the  past  two  years,  that  Malarial  fever  is 
and  will  be  in  future,  one  of  the  principal  diseases  which 
our  community,  especially  the  section  of  the  Neck,  will  be  liable 


78 


to,  such  steps  should  be  taken  as  to  endeavor  to  attain  eventu- 
ally complete  immunity;  and  temporarily,  partial  mitigation, 
of  the  evil.  Drainage,  complete  and  thorough,  based  upon  well 
known,  scientific  laws  and  knowledge  of  loeal  peculiarities,  the 
enforcement  of  ordinances,  looking  to  the  management  of  Pri- 
vate Hygiene,  a  system  of  complete  inspections  to  see  them 
executed  ;  and  above  all.  as  it  is  known  that  fever  of  a  periodical 
nature  will  be  prevented  from  showing  itself  by  its  favorite 
haunts  being  covered  with  a  good  pavement,  so  as  to  separate 
at  once  and  permanently  from  the  sun  and  air,  the  bed  of  moist 
putrefied  materials,  which  ferment  and  give  rise  to  the  contin- 
ual evolution  of  noxious  gasses,  a  system  of  shelling  or  pave- 
ing  the  streets,  should  be  commenced  and  pushed  through  with 
all  diligence  and  dispatch,  consistent  with  economy  and  pru- 
dencc.  But  even  after  this,  unless  there  be  enforcement  of  a 
regular  system  of  scouring,  their  surface  will  soon  be  covered 
with  semi-fluid  mud,  offal  and  vegetable  refuse,  which  will 
represent  faithfully  a  marsh  on  the  edge  of  ponds,  or  the  con- 
tents of  cess  pools  and  gullies. 

The  suggestions  above  arc  offered  with  all  due  deference,  as 
apparent  and  needed,  after  careful  observation  and  conviction, 
that  in  a  city  liable  (and  situated  as  ours  is)  to  these  peri- 
odical invasions,  active  and  energetic  steps  should  be  taken  to 
correct  the  evil. 

J.  SOMERS  BUI  ST,  M.  D. 

City  Physician, 
in  Charge  Jfth  Health  District. 


Annual  JJcpovt  of  health  gistrid  5. 


Charleston,  S.  C.  April  20(1),  1868. 
George  S.  Pelzer,  M.D..  City  Registrar,  &c: 

Sir: — I  have  the  honor  to  acknowledge  the  receipt  of  your 
communication  of  the  13th  April,  requesting  a  Report  upon  the 
sanitary  condition  of  that  portion  of  the  City,  over  which,  for 
the  last  year,  I  have  acted  as  Health  Officer,  and  for  such  sug- 
gestions for  its  improvement  as  I  may  deem  fit  to  make. 

Restricting  myself  as  much  as  possible,  avoiding  all  discussions 
upon  sanitary  principles,  and  assuming  the  correctness  of  those 
usually  recognized,  such  as  relate  to  Drainage.  Sewerage,  Water, 
&e.,  I  will  attempt  to  be  as  practical  as  possible,  confining 
myself  within  the  most  narrow  limits.  I  fear  that  the  principles 
governing  the  health  of  cities  has  been  very  much  neglected  by 
us  ;  not  because  we  have  been  unacquainted  with  them,  or  that 
we  have  been  indifferent,  but  simply  because  we  occupy  one  of 
the  most  salubrious  cities  upon  the  American  Continent,  for 
with  us  but  four  months  during  the  year  is  the  climate  injurious 
to  the  Caucasian.  Our  apparent  indifference  has  also  arisen 
from  another  cause.  Our  attention  has  been  concentrated  upon 
the  eradication  of  our  great  scourge,  the  Yellow  Fever,  and  in 
attempting  the  solution  of  problems  connected  with  its  origin 
and  propagation,  much  research  and  expense  has  been  in- 
curred. Fortunately  for  us,  the  attempt  at  the  prevention  of 
this  our  terrible  enemy,  if  not  efficacious  in  the  direction  aimed 
at,  has  been  at  least  beneficial  in  the  removal  of  the  causes  of 
some  other  diseases.  Most  of  the  sanitary  measures  have  thus 
been  carried  out  in  the  lower  portions  of  the  city,  at  those  points 
which  observation  has  taught  that  such  epidemics  take  their 
origin,  whilst  no  action  of  this  kind  has  been  attempted  in 
the  upper  Wards. 

Time  and  space  will  not  allow  an  analysis  of  the  geological 
formation  upon  which  the  city  is  built,  or  its  meteorological 
condition  ;  these  both  bear  upon  its  diseases.    J  can  only  speak 


80 


in  a  cursory  manner  of  the  surface  condition  of  that  portion 
over  which  tin's  District  extends. 

District  ~No.  5  is  embraced  in  that  portion  of  the  city  which 
is  Bituated  north  of  John  street,  and  its  continuation  Chapel, 
west  of  Town  Creek,  a  branch  of  Cooper  river,  south  of  the 
City  boundary,  near  the  junction  of  the  Meeting  street  and 
King  street  roads,  and  east  of  King  street ;  a  space  of  about 
one  mile  and  a  half  in  length,  and  half  a  mile  in  width,  exclu- 
ding the  mud  flats  which  lie  to  the  east.    Prior  to  the  city  ex- 
tending its  boundary  to  its  present  limits,  portions  of  these  flats 
ran  inwards,  but  as  necessity  required,  from  time  to  time,  in 
detached  spots,  some  of  these  low  places  were  filled  up  and  built 
upon.    This  continues  still,  as  at  the  termination  of  Aiken, 
Judith,  and  America  streets,  and  along  the  eastern  border  of 
the  District,  the  filling  being  only  sufficient  to  be  above  the  tide. 
The  material  was  usually  rubbish  and  the  scavenger's  offal. 
The  decomposition  of  such  material  requires  several  years,  and 
must  more  or  less  effect  health  by  the  continual  escape  of  gases. 
Nearly  one-half  of  the  District  has  been  built  upon  ;  the  re- 
mainder, although  laid  out  in  streets,  continues  to  be  used  as 
farms.   Its  surface  is  composed  of  a  stratum  of  yellow  sandy  loam, 
whose  depth  is  but  three  or  four  feet;  below  which  lies  a  thicker 
bed  of  fine  white  sand,  which  occasionally  crops  out  at  the  sur- 
face.   This  bed  is  so  saturated  with  water  as  to  make  it  resem- 
ble  quicksand,  by  which  term  it  has  been  described.  Below 
this  again  lies  a  dense  stratum  of  shells,  (post  pleiocene,)  imper- 
vious, and  keeping  the  water  of  the  beds  above  from  sinking, 
so  that  the  sand  beds  are  constantly  giving  up,  by  capillary 
action    and   an    evaporation,  a  large  amount  of  moisture. 
The  elevation  of  the  surface  is  but   by   a   few   feet  above 
high  water.    At  two  or  three  points,  small  sandy  ridges  run 
in  a  transverse  direction,  from  east  to  west,  the  highest  ele- 
vation of  which  does  not  exceed  eighteen  feet ;  about  six  feet 
would  be  the  average  height ;  its  greater  portion  is  but  a  few 
inches  ;  particularly  is  this  the  case  along  America,  Bay,  Aiken, 
John  and  Judith  streets.    Between  these  extremes  the  surface 
is  very  irregular,  few  lots  possessing  the  same  height,  and  man}' 
of  them  changing  from  year  to  year,  as  the  materials  by  which 
they  had  been  originally  filled  undergo  decomposition,  or  time 
and  the  fall  of  rain  renders  the  soil  more  compact.    These  lots 


SI 


require  constant  work,  and  either  become  bottoms,  or  must  be 
tilled  frequently  to  shed  the  ruin  which  lulls  upon  them. 
This  constant  variation  of  surface  interferes  materially  with 
t lie  surface  drainage,  as  that  adapted  for  one  year  is  not  avail- 
able in  the  next,  the  fall  of  rain  being  turned  in  one  direction  or 
another,  as  neighboring  lots  sink  or  arc  raised.  Thus  stagnant 
water  collects,  and  health  suffers.  A  fixed  level  should  be 
authorized  for  the  sidewalk  of  each  street,  and  the  surface  of 
all  lots  required  to  be  kept  up  to  this  grade,  so  that  the  water 
should  be  thrown  upon  the  streets,  to  be  drained  from  there. 

The  District,  consisting  almost  of  suburbs,  has  been  very 
much  neglected.  Its  drainage,  the  most  important  of  all  sani- 
tary measures,  is  very  defective.  It  may  be  said  to  have  no 
subsoil  drainage  at  all.  Its  surface  is  always  damp,  and  the 
edges  of  the  streets  near  the  wooden  curbing  has  almost  always 
water  lying  upon  it. 

Within  the  last  year  much  has  been  done  in  the  way  of  sur- 
face drainage,  for  the  removal  of  stagnant  water  ;  long  wooden 
drains  have  been  sunk  through  Aiken,  Columbus,  Hanover,  John 
and  Judith  streets.  Xo  sj^stematic  level  has  been  adopted  ; 
they  seem  intended  but  for  local  purposes.  It  is  more  than 
probable  that  the  benefit  of  these  drains,  even  as  imperfect  as 
they  are,  will  be  felt  this  coming  summer.  Above  Line  street, 
which  may  be  taken  as  the  dividing  line  between  the  farms  and 
the  city  proper,  very  little  even  of  surface  drainage  has  been 
accomplished.  A  few  ditches  have  been  sunk  along  the  sides  of 
the  most  important  roads,  more  for  the  purpose  of  keeping  them 
in  repair  than  for  any  other  object,  and  a  few  to  enable  the 
farms  to  be  cultivated.  This  deficiency  is  evinced  by  the 
fact  that  during  the  winter  months  these  farms  are  very  healthy, 
and  arc  the  resort  of  many  families  for  health  and  recreation  ; 
but  as  soon  as  the  hot  season  comes  on,  the  most  severe  types 
of  Malarial  Fever  attack  those  who  are  exposed  upon  them. 
The  white  laborer  suffers  each  season  ;  and  the  negro,  whose 
constitution  is  not  as  susceptible  to  the  influence  of  this  poison, 
does  not  escape  with  impunity.  In  but  one  small  part  of  the 
District  has  any  attempt  been  made  for  thorough  drainage.  In 
the  year  1857,  the  city  authorities,  impressed  with  this  neces- 
sity, inaugurated  a  plan  for  drainage  and  sewerage:  at  that 
time  some  drains  were  sunk',  and  others  were  to  be  constructed 
11 


as  soon  as  convenient ;  so  that  ultimately  the  entire  city  was  to 
be  intersected  by  a  network  of  underground  canals,  having 
streams  of  water  running  below  the  streets.  These  drains  were 
to  be  kept  clean  by  flushing.  Those  constructed  in  District  l$o. 
5  run  below  Meeting  street,  from  about  Columbus,  southward, 
and  from  Meeting,  through  Spring  street,  westward,  connecting 
at  Meeting.  At  intervals  they  were  provided  with  sinks  or 
sand  pits,  depressions  below  their  bottoms.  Above  these  sinks, 
for  the  purpose  of  removing  the  materials  which  would  collect, 
were  manholes,  communicating  with  the  surface,  and  covered 
by  large  iron  trap  doors;  culverts  near  the  curbing  of  the  side- 
walks give  passage  to  the  sewerage  and  the  rain.  For  subsoil 
drainage  this  system  has  not  answered  as  well  as  desired,  or  as 
it  first  promised.  The  amount  of  water  required  to  be  with- 
drawn had  been  under-estimated.  An  immense  amount  is 
retained  in  the  bed  of  quicksand,  extending  as  the  bed  does 
far  into  the  interior  of  the  State.  The  source  of  water  by 
which  this  bed  is  supplied,  is  from  the  rainfall  of  many  miles. 
Xot  being  able  to  sink  through  the  shell  bed  below,  the  water 
cannot  be  carried  downwards,  and  is  retained.  The  attempt  to 
remove  all  the  water  from  one  small  portion  of  such  a  receptacle 
must  be  futile,  as  it  will  again  be  supplied  from  other  portions 
of  the  bed.  Temporarily  the  drains  exhausted  the  water  from 
their  neighborhood,  as  was  observed  in  the  wells,  but  as  soon 
as  percolation  became  entirely  re-established  it  was  renewed.  To 
illustrate  the  immense  quantity  of  water  which  is  retained  under 
the  city,  it  is  only  necessary  to  refer  to  the  tubel  wells,  which 
have  recently  been  introduced  in  different  streets ;  by  them  it 
is  shown,  that  by  driving  a  pipe  down  and  pumping  out  the 
sand,  any  amount  of  water  could  be  obtained  from  this  bed. 
To  ensure  thorough  subsoil  drainage,  it  will  be  necessary  to 
dissever  the  city  portion  of  this  bed  from  that  of  the  country. 
For  sewerage,  these  drains  answer  somewhat  better.  A  defect 
seems  to  be  in  the  sand  pits ;  for  even  should  the  bottoms  of  the 
drains  be  kept  clean,  all  vegetable  and  animal  offal  whose  specific 
gravity  exceeds  that  of  water,  must  be  caught  in  them,  there  to 
undergo  putrefaction,  discharging  their  gases  at  first  into  the 
drains,  and  through  them  into  the  culverts  at  the  edges  of  the  side- 
walks. Disinfectants  may  destroy  the  smell,  but  can  only  render 
these  agents  more  injurious  from  their  remaining  undetected. 


83 


These  sinks  are  more  pernicious,  inasmuch  as  they  are  only 
cleansed  during  the  cool  months;  during  the  summer,  at  which 
time  putrefaction  is  more  active,  the  drains  are  kept  closed.  The 
large  amount  of  sewerage  removed  from  the  manholes  proves 
the  inadequacy  of  the  flushing  to  keep  the  drains  cleansed. 
^N"o  cellars  should  be  constructed,  and  all  that  have  formerly  heen 
built  should  be  filled  up  with  fresh  soil  from  the  country.  The 
importance  of  paving  t  he  streets  and  yards  should  not  be  over- 
looked. This  sanitary  measure  has  not  escaped  the  attention  of 
this  and  other  cities.  Its  advantages  have  been  exhibited  upon 
the  health  of  certain  streets  of  London,  and  elsewhere.  The  ben- 
efit of  having  some  material  of  a  non-porous  nature  interposed  be- 
tween the  heat  of  the  summer  sun  and  the  moisture  of  the  soil, 
in  the  prevention  of  disease,  has  proved  very  decided.  Meeting 
is  the  only  street  in  the  District  which  has  been  partially 
paved. 

The  streets  have  been  kept  as  well  cleansed  by  the  scavenger 
as  it  has  been  possible.  At  best  this  is  but  an  imperfect 
means  of  cleanliness,  especially  where  the  refuse  of  yards,  sta- 
bles and  kitchens  are  deposited  upon  the  surface  of  a  sandy 
street.  Some  portion  of  the  offal  will  escape  the  spade  of  the 
scavenger,  and  other  portions  of  the  semi-fluid  mass  Will  be  ab- 
sorbed and  incorporate  itself  with  the  soil. 

The  character  of  the  water  consumed  by  the  poorer  classes  is 
a  matter  of  grave  importance  to  the  community.  If  san- 
itary science  has  established  any  one  fact,  it  is,  that  there 
is  no  agent  so  pernicious  to  health  as  impure  water.  If  it  is 
true,  that  those  localities  in  which  the  water  is  impure 
have  always  suffered  most  severely  from  epidemics  of  zymotic- 
disorders,  particularly  from  Cholera,  Charleston  has  very 
much  to  dread.  The  water  used,  both  for  drinking  and  do- 
mestic purposes,  in  this  District,  is  as  impure  as  it  can  be.  It 
is  derived  from  the  numerous  shallow  wells  sunk  in  the  yards. 
The  appearance  of  this  water  is  clear  and  pclucid,  but  the  taste, 
and  the  slightest  chemical  analysis,  proves  it  to  contain  a  large 
amount  of  foreign  ingredients,  both  organic  and  inorganic.  The 
wcils  do  not  average  twelve  feet  in  depth,  frequently  only  four 
or  five.  Salts  from  the  harbor  pass  through  the  loose  porous 
soil  to  them.  Their  supply  Vicing  from  the  surface,  the  rains 
bear  along  with  it  the  washings  from  the  yards  and  the  fluids 


&4 


which  arc  thrown  out.  Yet.  as  had  as  this  is.  the  greater  im- 
purity is  from  the  proximity  of  the  privies,  a  few  feet  of  soil 
being  only  interposed  between  these  two  kinds  of  excavations, 
sufficient  to  remove,  by  its  filtering  action,  only  the  most  noxious 
portions.  Such  wells  should  be  filled  up  as  soon  as  a  good  sup- 
ply of  water  can  be  obtained.  The  Ashley,  the  Pee  Dee,  and  the 
San  tee.  have  each  at  different  times  been  recommended  for  this 
purpose.  But  it  should  he  borne  in  mind,  that  although  the  sources 
of  these  rivers  are  in  high,  healthy,  sandy  localities,  yet  the}'  flow 
through  malarial  flats  before  reaching  points  at  which  it  is  desi- 
rable to  tap  them  ;  these  waters  are  all,  more  or  less,  tinged 
with  soluble  vegetable  matter,  and  probably  certain  malarial 
poisons.  Particularly  is  this  likely  to  be  the  case,  if  malaria  has 
a  cryptogamic  origin,  as  Dr.  Salsbury  asserts,  and  Dr.  ITannor. 
Professor  of  Botany  in  Brussels,  seems  to  confirm.  These  plants 
arc  readily  wafted  along  by  water,  depending  upon  moisture  for 
their  production  and  support.  The  rainfall  of  the  city  is  more 
than  enough  to  supply  the  wants  of  the  inhabitants,  if  each 
residence  was  provided  with  a  cistern,  as  avcII  as  the  public 
buildings;  the  very  best  water  could  be  obtained  at  a  minimum 
expense.  Eacb  privy  sunk  should  be  walled  in,  and  the  walls 
and  bottoms  encased  with  hydraulic  cement,  so  as  to  prevent  per- 
colation. They  should  be  required  to  be  cleansed  once  a  year,  at 
least  until  a  system  of  tubel  drains  could  be  constructed,  con- 
necting them  with  the  harbor;  night  soil  is  remarkable  for  its 
solubility,  and  the  presence  of  the  water  twice  a  day  would  keep 
them  pure. 

There  are  several  burial  grounds  now  in  use  in  this  District : 
interments  should  be  stopped  in  them.  The  recent  Report  to 
the  City  Council  upon  this  subject  exhibits  the  danger  of  allow- 
ing them  to  be  used.  Junk  shops  should  be  banished  to  the 
city  boundary;  the  large  quantities  of  rags  collected  in  them 
must  contain  the  fomites  of  disease,  and  the  piles  of  bones  must 
be  injurious.  Butcher  pens,  candle  and  soap  factories,  and  the 
like,  should  only  be  permitted  on  the  outskirts,  and  over 
streams. 

The  dwellings  of  the  poor,  as  in  the  suburbs  of  most  Ameri- 
can cities,  consist  mostly  of  wooden  buildings,  loosely  and 
imperfectly  built.  The  manner  of  their  construction,  and 
the  wanl  of  repair  in   which  they  are  kept,  ensures  their 


85 


ventilation.  It  is  very  rare  that  crowding  is  observed. 
There  is  a  disposition  to  dose  up  the  chambers  of  the  very  sick 
among  the  uninformed,  but  there  is  no  difficulty  in  persuading 
the  friends  of  such  persons  to  permit  a  freer  supply  of  air  to 
them.  The  occupations  of  the  poor  is  generally  that  of  out-door 
work,  and  such  as  not  to  interfere  with  health.  The  neglect  of 
the  sick  among  the  uneducated  is  too  glaring  to  be  overlooked* 
Medical  aid  is  frequently  not  requested  until  too  late. 

Some  means  should  he  employed  to  provide  a  better  class,  of  mid- 
wives,  and  to  restrain  someof'thepresent  ones  from  acting.  Every 
old  colored  woman  thinks  herself  sufficiently  educated  to  act  in 
this  capacity,  and  physicians  are  called  upon  to  relieve  accidents 
which  should  never  have  occurred,  to  say  nothing  of  the  risk  of 
infantile  life,  and  that  of  the  mothers  which  such  want  of 
knowledge  entails. 

It  is  also  desirable  that  the  office  of  Coroner  should  he  filled 
from  the  medical  profession*  The  advantages  have  been  ac- 
knowledged where  this  plan  lias  been  adopted,  tending  to  pre- 
vent crime,  &c,  &c;  indeed  the  benefits  to  the  community  are 
so  numerous  and  obvious  that  it  is  not  necessary  to  dwell  upon 
them. 

It  w^ould  also  benefit  the  health  of  the  city  if  the  grass,  weeds. 
&c,  which  grow  along  our  sidewalks  be  allowed  to  remain  until 
the  cold  weather  takes  place;  the  practice  hitherto  has  been  to 
cut  them  up  during  our  hottest  months  ;  and  although  the  ap- 
pearance of  the  streets  are  improved  thereby,  the  effects  of  the 
exposure  of  a  new  surface,  and  the  decomposition  of  the  weeds, 
must  be  injurious.  A  much  larger  number  of  trees  should  be 
planted,  as  tending  by  their  shade  to  modify  the  severe  heat  of 
the  summer,  and  purify  the  atmosphere  by  the  chemical  change 
which  growing  vegetations  produces. 

The  only  epidemic  which  prevailed  last  year,  took  place  du- 
ring the  summer  and  autumnal  months.  It  was  of  malarious 
character,  presenting  all  the  varieties  of  this  disease — two  or 
three  cases  of  so  severe  a  type  as  to  resemble  yellow  fever. 
The  immediate  origin  of  this  epidemic  I  am  at  a  loss  to  locate  ; 
whether  it  arose  from  causes  within  the  District,  or  from  the 
neighboring  farms.  I  am  unable  to  say.  Diseases  of  this  class 
have  prevailed  in  this  neighborhood  every  summer. 


80 


Id  concluding  this  hastily  written  Report,  J  would  direct  at- 
tention to  the  fact,  an  instance  of  which  was  exhibited  last  year 
in  this  epidemic,  that  the  mortuary  returns  are  no  criterion  of 
the  health  of  a  city  ;  a  period  may  be  very  unhealthy,  and  ye< 
these  tables  present  no  record  of  the  same.  The  number  of 
deaths  arc  but  an  index  of  the  nature  and  severity  of  disease, 
and  to  adopt  the  words  of  Mr.  Rumsey,  as  quoted  in  the  Amer- 
ican Journal  of  Medical  Science,  July,  18G1,  "a  diminution  in 
the  rate  of  mortality  will  be  found  to  co-exist  generally  with  an 
augmentation  of  the  rate  of  sickness.*'  "The  total  sick  time 
measures  the  amount  of  disease.  Medical  records  display  its 
nature  and  cause.  The  number  of  deaths,  according  to  sex  and 
age,  determine  its  intensity.*'  Now,  as  a  necessary  result  of 
improvement  in  domestic  management  and  medical  treatment, 
and  owing  to  the  removal  of  those  more  virulent  agents  of 
destruction,  which,  by  sharp  and  decisive  strokes,  prematurely 
sever  the  thread  of  life,  its  duration  has  been  lengthened  in  our 
great  cities.  But,  at  the  same  time,  the  sickly  and  infirm  pe- 
riods of  existence  has  been  prolonged,  probably,  in  a  greater 
degree  than  even  life  itself.  Chronic  diseases,  or  at  least  func  - 
tional disorders,  have  increased.  Vital  force  is  lowered,  man's 
work  is  arrested,  his  duties  are  unperformed,  his  purposes  fail, 
though  he  still  lives.  Weakly,  diseased  children,  are  now  more 
mercifully  helped,  as  they  never  were  in  olden  time,  to  grow  np 
into  weakly,  ailing  adults,  who  in  their  turn  propagate  with 
abnormal  fecundity  and  unsound  progeny.*' 

Tt  is  from  epidemics  such  as  that  through  which  we  have  just 
passed  that  this  personal  diminution  of  vitality  is  engendered. 
Few  agents  so  productive  of  impairment  of  constitution  as 
that  of  malaria,  are  recognized — exhibiting  its  depressing  influ- 
ence even  for  years  after  its  first  effects  have  passed  away  ;  and 
no  agent  is  so  easily  removed  by  sanitary  precautions. 


(Signed)    J.  FORD  PRIOLEAU,  M.I). 


City  Hospital  for  Refugees  and  Seamen,  Hampstead,  ) 

Charleston.  January^  1868.  *  ) 

Dr,  GrEO.  S.  PeLZER,   Chief  Of  Health  Department: 

Sir: — In  forwarding  to  you  the  annua)  statement  of  the 
diseases  treated  in  this  Hospital.  I  append  a  classified  list  of  the 
same,  including  those  of  Seamen.*  Of  the  last  mentioned, 
eighty-one  have  been  received  and  treated.  It  will  be  observed 
that  there  has  been  but  one  death  in  this  number,  which  was 
from  yellow  fever.  This  case  was  admitted  in  December,  and 
occurred  in  a  seaman  just  arrived  from  Cuba.  He  survived  only 
twenty  hours  after  admission.  The  character  presented  by  this 
ease,  the  existence  of  black-vomit,  and  the  autopsy,  left  no 
doubt  as  to  the  nature  of  the  disease;  and  there  is  every  reason 
to  believe  that  it  was  the  only  case  which  occurred  in  Charleston 
during  the  past  season. 

There  was  an  unusual  prevalence  of  malarial  diseases,  many 
of  them  of  severe  grade.  The  numbers  were,  one  hundred  and 
eighteen  cases  of  intermittents,  twenty-four  of  remittent,  and 
nine  of  the  congestive  form  ;  total,  151.  Of  these  there  were 
three  deaths,  which  were  confined  to  the  congestive  cases.  Two 
of  the  three  survived  but  a  few  hours  after  entering  the  Hos- 
pital. 

An  accurate  and  full  record,  in  detail,  in  a  case  book,  is 
kept  of  all  the  cases  treated  in  the  Institution. 

It  will  be  observed  that  I  have  only  reported  the  work  per- 
formed by  me  since  the  Hospital  was  removed  to  the  Tucker 
House  in  June  last.  The  cases  treated  by  me  during  the  pre- 
vious six  months,  whilst  in  charge  of  the  Mazyck  street  Hospi- 
tal, will  be  embraced  in  the  report  of  Dr.  S.  Chatburn  Brown, 
in  charge  of  that  Institution,  now  reserved  for  the  reception  of 
Freed  men. 

The  Hampstead  Hospital  is  well  located,  in  a  healthy  neigh- 
borhood, and  the  hygienic  influences  are  highly  favorable.  The 


*  The  Diseases  embraced  in  the  Tabular  list  referred  to  are  included  in 
the  Health  Department  Report,  without  the  Seamen's,  which  have  n<>t  been 
published. 


88 


Wards  appropriated,  both  to  mules  and  females,  are  airy,  well 
ventilated,  neatly  kept,  and  afford  as  great  a  degree  of  comfort 
as  could  be  desired. 

[  beg  to  state  that  my  Apothecary,  Dr.  T.  Grange  Simons, 
who  also  performed  the  duties  of  House  Physician,  has  given 
his  earnest  and  zealous  attention  to  the  work  entrusted  to  him, 
and  lias  efficiently  seconded  me  in  the  effort  made  for  the  relief 
and  comfort  of  the  inmates. 

I  cannot  conclude  my  Report  without  also  commending  the 
assiduous  and  diligent  manner  in  which  my  Steward,  Mr.  Tor- 
la)',  and  his  assistants,  have  performed  their  various  duties. 
Very  respectfully, 

F.  PBYEE  POECHEE,  M.D., 
Surg con  in  Charge. 


City  Hospital.  Mazyck  Street,  ) 
Charleston,  January  1,  18GS.  j 

Dr.  George  S.  Pelzer,  City  Registrar,  &c.,  of  H.  I). 

Sir: — Until  last  May.  the  City  Hospital,  Mazyck  street,  re- 
mained as  at  date  of  my  last  Report,  January  1st,  18G7 — the 
Refugees  under  the  care  of  Dr.  F.  Peyre  Porcher,  the  Freedmen 
and  Insane  under  my  charge,  in  separate  and  distinct  apart- 
ments. 

A  necessity  having  arisen  for  increased  accommodations,  from 
the  crowded  state  of  the  Wards,  and  tjie  great  number  of  appli- 
cations for  Hospital  relief,  a  suitable  building  was  leased,  and 
the  Refugees  moved,  thus  leaving  the  apartments  formerly  oc- 
cupied by  them,  having  first  undergone  extensive  alterations 
and  improvements  under  your  immediate  direction,  for  the 
Freedmen. 

As  will  be  seen  by  reference  to  the  accompanying  Report, 
there  have  been  six  hundred  and  eighty  (G80)  Freedmen,  and 
one  hundred  and  eighty  (180)  Refugees  admitted  and  treated 
during  the  past  twelve  (12)  months,  involving  almost  eveiy 
variety  of  case.  Medical,  Surgical,  and  Obstetrical ;  the  mortality 
among  the  Freedmen  being  one  in  five  and  two-thirds,  (5f,) 
whilst  among  the  Refugees  but  one  in  fifteen  (15.)  This  com- 
pares favorably  with  that  of  the  previous  year. 

It  should  be  borne  in  mind  that  many  cases  reported  as  hav- 
ing died  in  the  Hospital  were  in  a  moribund  condition,  when 
admitted  ;  some  were  not  even  taken  to  the  Wards.  The  pa- 
tients usually  received,  are  those  who  have  been  most  neglected, 
deprived  not  only  of  food,  but  of  shelter;  and  where  shelter  may 
have  been  afforded,  it  was  in  ill  ventilated  and  crowded  apart- 
ments. 

The  very  large  proportion  and  increase  in  the  number  of 
cases  of  Struma  and  Tubercle  among  the  Freedmen,  is  a  matter, 
I  think,  worthy  of  remark,  confirmatory  of  the  experience  of 
Dr.  McGuire,  Professor  of  Surgery  of  Virginia  Medical  College, 
and  Physician  in  charge  of  Freednien's  Hospital  at  Richmond. 


90 


Scrofulous  Ulcers,  Scrofulous  Abscess,  Tuberculosis  of  Joints, 
Tuberculous  Deposits  in  the  Lungs,  or  other  Organs,  Scrofulous 
swelling  of  the  Glands,  &c,  are  so  general,  that  more  than 
ninety-five  hundredths  (95-100)  of  the  patients  admitted  to  this 
Hospital  are  more  or  less  thus  affected,  and  every  autopsy  that 
has  been  performed  has  confirmed  most  strikingly  this  truth. 

Quite  a  large  number  have  been  admitted  to  the  Insane  De- 
partment from  time  to  time,  beingtransferred  to  the  Asylum  at 
Columbia  as  the  necessities  of  the  case  required.  Though  the 
stay  of  such  cases  at  this  Hospital  is  usually  very  short,  it  is 
greatly  to  be  regretted  that  the  conveniences  for  treatment,  and 
the  arrangements  of  this  special  apartment,  are  from  necessity 
so  imperfect. 

The  number  of  patients  daily  under  my  care  has  averaged 
over  one  hundred  and  thirty  (130.) 

It  affords  me  much  pleasure  to  bear  testimony  to  the  prompt 
and  faithful  manner  in  which  the  officers  and  attendants  at  this 
Hospital  have  discharged  their  duties.  To  Dr.  C.  W.  Horsey 
and  Mr.  Andrew  Yates,  Apothecary  and  House  Physician,  as 
well  as  Mr.  Arthur  Fairley,  Steward,  I  am  particularly  indebted 
for  valuable  assistance,  which  they  have  at  all  times  so  cheer- 
fully rendered. 

Very  respectfully, 

S.  CHATBUEX  BPvOWN.  M.D., 

City  Physician  in  Charge. 


Date  Due 


— Anu  '  -v^ft  t  1 

Z  OO  j  ( 

577:  — — - — rrn  

JUL  2  5  W 

mti  1  5  '4& 

CM 

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Form  335 — 35M — 9-34— C,  P.. Co. 


36 
L 


97  5.7  Z99C  1860-79  v. 3  no. 43-60 

32)5521 


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